Prior Authorization Specialist I

Accountabilities:

• • Submit prior authorization requests using established payer workflows, protocols, and system requirements.
  • Verify basic patient benefits, coverage details, and authorization requirements.
  • Monitor authorization requests and track their status through completion.
  • Accurately document authorization activity and updates within Epic and other applicable systems.
  • Identify incomplete, unusual, or non-standard cases and escalate them according to established procedures.
  • Collaborate with departments across the organization to support efficient authorization workflows and timely resolution of issues.
  • Follow required documentation, compliance, accuracy, and timeliness standards when processing requests.
  • Develop proficiency with Epic, payer portals, and related healthcare administrative systems.
  • Perform other duties and responsibilities as assigned.

  Requirements:

  • High school diploma or GED required.
  • No prior professional experience is required, making this an opportunity suitable for candidates entering healthcare administration.
  • Foundational understanding of payer types, referrals, prior authorizations, or healthcare coverage concepts is beneficial.
  • Ability to follow standardized workflows, protocols, and documentation requirements consistently.
  • Strong attention to detail with a demonstrated commitment to accuracy, timeliness, and compliance.
  • Ability to learn and effectively use Epic, payer portals, and other technology platforms.
  • Good written and verbal communication skills.
  • Ability to collaborate effectively with colleagues across different departments.
  • Strong organizational skills and the ability to manage authorization-related tasks reliably.

  Benefits:

  • Full-time employment with a healthcare organization.
  • Paid time off (PTO).
  • 401(k) retirement plan.
  • Medical insurance.
  • Dental insurance.
  • Comprehensive benefits designed to support employees' health, financial security, and overall well-being.
  • Opportunities to develop healthcare administration and prior authorization expertise.
  • Supportive environment with opportunities to build a long-term career in healthcare operations.